Tabanella Giorgio, Nowzari Hessam, Slots Jorgen
Advanced periodontics, University of Southern California School of Dentistry, Los Angeles, CA, USA.
Clin Implant Dent Relat Res. 2009 Mar;11(1):24-36. doi: 10.1111/j.1708-8208.2008.00088.x. Epub 2008 Apr 1.
The failure of the host tissue to establish or maintain osseointegration around dental implants is due to either occlusal or parafunctional forces, premature loading, ill-directed stress, or microbial infection. The long-term failure rate of dental implants is generally 5-10%. Although a variety of etiologies of early peri-implant bone loss (from implant placement to 1-year post-loading) have been proposed, factors associated with late implant failures are less well understood but are probably related to both the peri-implant microbial environment and host factors. Discriminating between causes of implant failure is of importance for instituting a successful implant therapy.
The objective of this cross-sectional split-mouth study was to identify clinical, radiographic, and bacterial characteristics of peri-implant disease sites.
Fifteen patients with bilateral implants (Brånemark, Nobel Biocare AB, Göteborg, Sweden; and 3i implant systems, Implant Innovations Inc., Palm Beach Gardens, FL, USA) participated in the study. Sites with peri-implant (radiographic bone loss beyond the third implant thread) and peri-implant healthy tissues (radiographic bone level above the first implant thread) were identified in periapical radiographs using a long-cone paralleling projection technique. Microbiological identification was carried out using established anaerobic culture techniques. A descriptive statistics based on means and standard deviations was reported.
Peri-implant bone loss was associated with the absence of radiographic crestal lamina dura, peri-implant pocket depth, pain on chewing, and the submucosal presence of the putative periodontopathogens Tannerella forsythia, Campylobacter species, and Peptostreptococcus micros. Pain was associated with P. micros, Fusobacterium species, and Eubacterium species.
The absence of radiographic crestal lamina dura and the presence of suspected major periodontal pathogens seem to be associated to peri-implantitis.
宿主组织未能在牙种植体周围建立或维持骨整合是由于咬合或副功能力、过早加载、应力方向不当或微生物感染。牙种植体的长期失败率通常为5%-10%。尽管已经提出了多种早期种植体周围骨丢失（从种植体植入到加载后1年）的病因，但与晚期种植体失败相关的因素了解较少，可能与种植体周围微生物环境和宿主因素都有关。区分种植体失败的原因对于制定成功的种植治疗方案很重要。
本横断面双侧对照研究的目的是确定种植体周围疾病部位的临床、影像学和细菌学特征。
15例双侧植入种植体的患者（瑞典哥德堡诺贝尔生物保健公司的Brånemark种植体和美国佛罗里达州棕榈滩花园种植创新公司的3i种植系统）参与了本研究。使用长锥平行投照技术在根尖片上识别种植体周围（种植体螺纹第三层以外的影像学骨丢失）和种植体周围健康组织（种植体螺纹第一层以上的影像学骨水平）。使用既定的厌氧培养技术进行微生物鉴定。报告基于均值和标准差的描述性统计数据。
种植体周围骨丢失与影像学嵴顶硬骨板缺失、种植体周围袋深度、咀嚼痛以及牙周可疑病原菌福赛坦纳菌、弯曲杆菌属和微小消化链球菌的黏膜下存在有关。疼痛与微小消化链球菌、梭杆菌属和真杆菌属有关。
影像学嵴顶硬骨板缺失和可疑主要牙周病原菌的存在似乎与种植体周围炎有关。
